Two surgeries together bring peace of mind after breast cancer

The Reverend Laura Minnich Lockey, 50, of Harrisonburg, has always been healthy and on the go. So when she found a breast lump during a self exam, her first thought was, “What in the heck is that?” She was surprised because she regularly performed self-examinations.

A diagnostic mammogram revealed cause for concern. After reviewing her mammogram, the radiologist told her, “You should have a biopsy today, and you need to see the surgeon on Monday when she gets back.”

The biopsy, performed the same day as her mammogram, confirmed the lump was malignant.

Laura saw Sentara RMH Medical Center breast care surgeon Dr. Heidi Rafferty, who advised her to have chemotherapy, followed by surgery with immediate reconstruction. Dr. Rafferty explained that she and plastic and reconstructive surgeon Dr. Saied Asfa perform tandem surgery on many of her breast cancer patients.

It’s best for patients psychologically.

“They don’t have to deal with the challenges of seeing themselves without breasts,” says Dr. Asfa. “When they wake up, that’s it.”

Beginning the Journey of a Cancer Survivor

Laura began seeing medical oncologist Dr. Christine Urbanski for chemotherapy at the RMH Hahn Cancer Center. Her three tumors shrunk significantly, and the suspicious scattering that had previously been seen on scans disappeared.

“Dr. Rafferty and Dr. Urbanski explained that by doing chemo before surgery, they could see if the tumors were shrinking, and that would tell them the chemo was the right one, in case the cancer happened to come back,” Laura says. “Dr. Rafferty also said there would be a better aesthetic outcome if the tumors were smaller when she removed the breast tissue.”

Bilateral Mastectomy with Breast Reconstruction

Even though the cancer had responded well to chemotherapy, Laura decided to have bilateral mastectomies (removal of both breasts), instead of breast conservation surgery, or lumpectomy, which involves removing just the tumor and a small margin of normal tissue surrounding it, followed by radiation therapy. Removal of the normal tissue and radiation are precautions to ensure that no cancer cells remain.

The availability of tandem breast surgery also played a significant role in her decision.

Recovery and Follow-Up

Laura spent three nights in the hospital after her surgery. Then she went home and spent three weeks in bed.

“Sometimes during my recovery, I wondered if I should have just gone for the straight mastectomy without reconstruction, and I’d have been done,” she says. “But then I would see pictures of women who had gone that route, with all the scars, and I’d think, ‘I would not have wanted that.’ Because I did the immediate reconstruction, I never looked down and saw flat.”